Nicoletis C
Chirurgie plastique, Hôpital Saint-Antoine, Paris.
Chirurgie. 1990;116(3):341-6.
Experience with 600 operations, including 200 second-look operations, for the management of lipodystrophy, fatty excess and other unsightly affections of the abdominal wall allows defining a few essential elements. The routine procedure consists in lowering the supraumbilical curtain down to the pubis after transposition of the umbilicus. This is indicated in case of considerable supraumbilical skin excess, and requires spreading the board flap with properly distributed tensions. The achievement of a beautiful curve must prevail upon the position of the scar, which is however located in the inferior abdominal crease as a rule, extending up the iliac crests. If there is less supraumbilical skin, minimal procedures can be considered, also with the major aim of obtaining a sightly curve. On a whole, it is important to emphasize that obtaining a small scar is not a goal in itself, the true hope being the restoration of a satisfactory curve of the abdominal wall.
对600例手术（包括200例二次探查手术）进行腹壁脂肪代谢障碍、脂肪过多及其他不雅外观问题的治疗经验，有助于确定一些关键要素。常规手术步骤包括在脐移位后将脐上皮肤皮瓣向下拉至耻骨。这适用于脐上皮肤大量多余的情况，且需要在适当分布张力的情况下展开皮瓣。实现优美的曲线应优先于瘢痕的位置，不过瘢痕通常位于下腹部皱襞处，向上延伸至髂嵴。如果脐上皮肤较少，可以考虑采用微创手术，主要目的同样是获得美观的曲线。总体而言，必须强调的是，获得小瘢痕本身并非目标，真正的期望是恢复令人满意的腹壁曲线。
